病例报告:基于虚拟现实的手臂和腿部自行车运动与经皮脊髓电刺激相结合,用于一名颈椎脊髓损伤患者的早期治疗

Xiaolei Chu, Shuaiyi Liu, Xiaoxuan Zhao, Tao Liu, Zheng Xing, Qingwen Li, Qi Li
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脊髓损伤是一种影响中枢神经系统的疾病,会造成神经损伤点以下不同程度的功能障碍。一名 50 岁的妇女因车祸导致颈部受伤。在接受一侧颈椎 C3-C6 后路钛板内固定术和 C7 椎板减压术后,患者被诊断为 C3-C7 颈椎间盘突出症和椎管狭窄症,导致脊髓持续受压。在对患者进行虚拟现实手臂和腿部骑行以及经皮脊髓电刺激的综合治疗后,根据 ASIA 评分,患者的感官和运动能力均有显著提高。根据汉密尔顿焦虑测试和汉密尔顿抑郁测试,患者的焦虑和抑郁程度均有所减轻。根据 SCIM-III 的评估,患者的自立能力和完成日常任务的能力不断增强,从而恢复了他们的功能。因此,使用基于虚拟现实技术的手臂和腿部骑行以及经皮脊髓电刺激有可能对脊髓损伤患者的功能产生积极影响。然而,由于这是一份病例报告,患者人数较少,而且干预是在伤后早期开始的,我们无法将干预带来的恢复与众所周知的脊髓损伤后最初几周和几个月的自然恢复区分开来。因此,有必要进一步开展大样本量的随机对照试验。
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Case report: Virtual reality-based arm and leg cycling combined with transcutaneous electrical spinal cord stimulation for early treatment of a cervical spinal cord injured patient
Spinal cord injury is a condition affecting the central nervous system, causing different levels of dysfunction below the point of nerve damage. A 50-year-old woman suffered a neck injury as a result of a car accident. After undergoing posterior cervical C3–C6 internal fixation with titanium plates on one side and C7 lamina decompression, the patient, who had been diagnosed with C3–C7 cervical disk herniation and spinal stenosis causing persistent compression of the spinal cord, was transferred to the rehabilitation department. After implementing the combined therapy of Virtual Reality-based arm and leg cycling along with transcutaneous electrical stimulation of the spinal cord, the patients experienced a notable enhancement in both sensory and motor abilities as per the ASIA scores. The patient’s anxiety and depression were reduced as measured by the Hamilton Anxiety and Hamilton Depression Tests. As evaluated by the SCIM-III, the patient’s self-reliance and capacity to carry out everyday tasks showed ongoing enhancement, leading to the restoration of their functionality. Hence, the use of Virtual Reality-based arm and leg cycling along with transcutaneous electrical spinal cord stimulation has potential to positively impact function in patients with spinal cord injury. However, as this is a case report, the small number of patients and the fact that the intervention was initiated early after the injury, we were unable to separate the recovery due to the intervention from the natural recovery that is known to occur in the initial weeks and months after SCI. Therefore, further randomized controlled trials with a large sample size is necessary.
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